Post-Traumatic Stress Disorder by Lauren Seers

Post-traumatic stress disorder (PTSD) is an anxiety disorder that affects individuals who witnessed or experienced a traumatic event. For someone to be diagnosed with PTSD, the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) requires a person to have experienced, witnessed, or be confronted with an event that involves actual or threatened death, serious injury, or a threat to their physical integrity, such as rape. Events that can cause PTSD include domestic abuse, assault, prison stay, terrorism, war, and natural disasters.

There are three categories of symptoms: reliving the event, avoidance, and arousal. When someone relives the event, they suffer from flashback episodes, and nightmares, and are very uncomfortable in situations that remind them of the event. Avoidance is when the person becomes emotionally numb; they no longer care about anything and start to feel detached. They are unable to remember important aspects of the trauma and have an overall lack of interest in normal activities. The third category, arousal, is when the person has difficulty concentrating, they are easily startled, is very irritable, displays outbursts of anger, and usually has difficulty falling asleep or staying asleep. There are no tests to determine whether or not someone has PTSD, so diagnosis is solely based on symptoms.

Desensitization is one form of treatment for PTSD. The person suffering from this disorder is encouraged to remember the traumatic event and express their feelings about it. This is usually done under doctor supervision, and the goal is that over time, the memories should become less frightening.  Antidepressants, anti-anxiety, and sleep medications are usually prescribed as well. If a person who suffers from PTSD does not seek help, they are more likely to develop alcohol and substance abuse problems. They are also more likely to commit suicide.

It is estimated that 70% of adults in the United States have experienced at least one traumatic event; approximately 20% of these people will develop PTSD. One in five military personnel returning home from Iraq and Afghanistan has already developed PTSD.  After the terrorist attacks on the World Trade Center in 2001, an estimated 10,000 firefighters and police officers developed PTSD; approximately 700 reported that they were still displaying symptoms in 2011.

Although PTSD is still not completely understood, it is known that brain function changes in patients with PTSD. Three areas of the brain change after experiencing a traumatic event: the hippocampus, amygdala, and the medial prefrontal cortex. The hippocampus is involved in memory and emotional processing. Patients who suffer from PTSD have a smaller hippocampus than a person who does not.

The amygdala is responsible for the fear response and regulating “fight-or-flight,” and it also links emotions with specific memories. The amygdala is hyperactive in patients with PTSD which explains why a person with PTSD has exaggerated responses when they are startled. The medial prefrontal cortex is responsible for regulating our fear response and is usually under-reactive in PTSD patients. Not only does brain function change, but stress hormones do as well. Cortisol levels are lower while epinephrine and norepinephrine levels are too high. Elevated levels of epinephrine and norepinephrine are what cause patients to suffer from high anxiety and restlessness.

References

PubMed Health

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001923/

Heal My PTSD

http://healmyptsd.com/education/post-traumatic-stress-disorder-statistics

Youtube – How does PTSD Affect Brain Function

National Alliance on Mental Illness http://www.nami.org/Template.cfm?Section=PostTraumatic_Stress_Disorder&Template=/ContentManagement/ContentDisplay.cfm&ContentID=68535